Drunk Uncle Sam Can’t Afford This Bender Forever

Obamacare: No Medicaid Expansion in Utah

I will explain why I have opened a bill file to refuse the Obamacare expansion of Medicaid in Utah.

Background:

The Supreme Court ruled that states are not forced to expand Medicaid to cover Obamacare’s insurance mandate. Utah now can choose whether to expand Medicaid (instead of losing all Medicaid funding by refusing to expand, as Obamacare intended). Medicaid is the fastest growing part of Utah’s budget, growing from 10% of the state budget a decade ago to 20% currently.

The Obamacare expansion would provide government insurance to additional categories (e.g., adults without children) and to more people within existing categories (e.g., adults with children would be eligible, if they made 133% of the poverty level, instead of the present 50%). The federal government initially would cover most of the Medicaid expansion costs.

Analysis:

1. Government v. the People: American government gets its power from individuals. At some point (which I think we have crossed), the growth of government means the diminution of people. People—allowed by a limited government to exercise their freedom and liberty—have made America great. Government has not made America great. In my opinion, President Obama disagrees with that perspective. As a result, he and Obamacare promote governmentalism, at the expense of individual freedom and liberty. People increasingly are working to support their government, instead of government working to protect the freedom and liberty of individuals. I oppose that power shift.

2. The hollowness of Government promises. The same government that attacks Utah—by shutting down drilling in Utah and pulling millions of acres out of “multiple use” management, to gain favor with special interest groups—promises Utah that it will give huge federal matches to fund Medicaid expansion. Yes, that would be the same government that has pulled back such matches in the past and that imposes requirements sure to escalate state costs. Color me skeptical. Also, the “free” money, of course, isn’t free. Our drunk Uncle Sam can’t afford this bender forever. What can’t go on forever, won’t. States ultimately will be expected to cover the expansion costs.

3. Even with the matches, Utah’s outlay would be huge. In 10 years, Utah’s costs for the expansion easily will exceed $100,000,000. That is money that won’t be available for education and transportation.

4. It’s not up to Utah to fix the problems of Obamacare. By not expanding Medicaid, a “doughnut hole” will be created. The “state insurance exchange” allows people earning over 133% [ed: corrected from original post] of the poverty level to receive subsidies for the purchase of insurance. If we don’t expand Medicaid, many people earning less than that amount won’t qualify for Medicaid but also won’t qualify for the subsidies. That is the “doughnut hole.” Rather than spend lots of resources to plug the hole in a bad law, we should work to repeal the law or maybe do away with the state exchange.